Adjunct Preceptor Perceptions of Motivation, Understanding, and Support for the Precepting Role.

OBJECTIVE: To determine adjunct pharmacist preceptor perceptions of their precepting role related to three domains: motivation to precept, understanding the precepting role, and support for precepting. METHODS: An online cross-sectional survey of 2429 adjunct preceptors for four schools of pharmacy was conducted. Participants ranked their agreement with 81 statements regarding the three domains, including eleven subdomains. RESULTS: Mean scores for the three domains were slightly below the positive response level, with lower scores found for the subdomains of workload, precepting norms, and extrinsic benefits/rewards. Individual statements indicated increased workload due to precepting, need for more preceptor recognition and appreciation, perceptions that precepting was stressful or draining, and a preference for one concurrent learner. More frequent need for extra coaching for APPE students negatively impacted all domains, including nine subdomains. CONCLUSION: This study provides a formal evaluation of adjunct preceptor perceptions of their precepting role. Compared to previous studies, these results may indicate lower satisfaction with precepting, suggesting opportunities exist to improve the adjunct precepting experience. Actions by schools/colleges of pharmacy are necessary to ensure experiential education capacity including addressing workload concerns, increasing preceptor recognition and appreciation, and supporting preceptors when students need extra coaching.

What Types of Data are Pharmacy Education Scholars Using in their Abstracts for Poster Presentations?

OBJECTIVE: The objective of this study was to describe the data being used to support poster presentations in pharmacy education scholarship. METHODS: Research and education posters presented at the 2020 American Association of Colleges of Pharmacy Annual Meeting were unitized to isolate text to be coded, and two coders categorized the quantitative and qualitative data by type and source. Questionnaires, instruments, and exams were categorized as new (ie developed and used for this particular inquiry) vs. existing. Qualitative data types were categorized as interviews, focus groups, self-reflections, analysis of student work products (eg lab reports assessed for student understanding), comments (ie written or verbal comments), and other (eg course reports). RESULTS: Two hundred and sixteen abstracts were included in the analysis, with 80 (37%) of abstracts relying on data derived from respondent's perceptions. Further, 143 abstracts (66%) used at least one new questionnaire, instrument, or exam. In 57% of the cases where multiple data sources were used, the study involved interprofessional education (eg multiple health professions learners) or pharmacy student-investigator combinations, and 28 abstracts (13%) did not use pharmacy students as a source. Less than 5% of all abstracts analyzed used traditional qualitative methods of interviews and focus groups. CONCLUSION: This study can open conversations around how to improve the quality of pharmacy education research and the identification of areas within the scholarship of teaching and learning that may benefit from improvement.

Implementation and evaluation of a practice transformation advanced pharmacy practice experience.

BACKGROUND AND PURPOSE: Advanced entrepreneurship opportunities are important to consider as entrepreneurial skills become increasingly important to develop in pharmacy students. This institution implemented a new practice transformation advanced pharmacy practice experience (APPE), pairing students with community partners to implement and/or evaluate pharmacy services, network with pharmacists, and receive mentorship. The purpose of this article is to describe the APPE and students' outcomes during this first pilot year. EDUCATIONAL ACTIVITY AND SETTING: A faculty preceptor mentored and oversaw all APPE activities. Students were selected through an application process, and community partners were recruited based on alignment with students' goals and need for student assistance. Community partners prepared a list of practice transformation activities needed at their sites, and progress was tracked during weekly virtual meetings. APPE students completed a pre-APPE questionnaire, collecting background information and predictors of entrepreneurship: proactive personality, entrepreneurial self-efficacy, and individual entrepreneurial orientation (IEO). At the end of the APPE, IEO was measured again, and students reflected on what skills were developed. FINDINGS: Three students participated in the first year and were paired with various community partners. IEO baseline scores ranged from 24 to 28 (mean = 25.3, SD = 2.3), and follow-up scores increased to 28 to 30 (mean = 29.0, SD = 1.0). Students reported development in both soft and technical skills. SUMMARY: The practice transformation APPE offered students a unique opportunity to develop a diverse set of skills during a focused five-week experience. Based on positive feedback from students, this institution plans to continue to expand this APPE.

Capturing employer's perceptions of key variables in exceptional new practitioners' success by using a modified Delphi process.

INTRODUCTION: The primary aim was to determine the key variables in a new practitioner's success from the perspective of pharmacy employers. A secondary aim was to describe the use of a modified Delphi process to collect quality information from external constituents. METHODS: A historical review of the literature was conducted to ensure the inquiry extended existing thinking and to aid the development of questions. An asynchronous, online two-round modified Delphi process was used to gather input and develop consensus. The findings were verified by crosswalking with the Habits of Mind. Additionally, the strategies for inviting panelists, practitioner response rates, and the amount and quality of the data collected were examined. RESULTS: The historical review yielded 25 articles that were categorized by disciplines studied, methods used, and characteristics found. Fourteen seasoned employers participated. Nine themes describing the behaviors and practices of exceptional new practitioners were identified. These themes were categorized into three groups: Change-Leader, Self-Manager, or Relationship-Builder. Additionally, all the themes mapped to multiple Habits of Mind. As a method for constituent input, the Delphi process yielded employer response rates per school ranging from 10% to 67% and produced five single-spaced pages of text (2124 words) for analysis. CONCLUSIONS: These descriptions of behaviors and practices of exceptional new practitioners build upon existing literature and provide additional guidance for professional development curricula. Additionally, an asynchronous, online Delphi panel can be a useful method to glean important insights from experienced pharmacy employers.

Evaluating the Impact of Advanced Pharmacy Practice Experiences on Student Pharmacist Metacognition.

Objective. To assess factors impacting metacognition during the advanced pharmacy practice experience (APPE) year (final year of the Doctor of Pharmacy program) for student pharmacists at five different institutions.Methods. Student pharmacists completed a pre- and post-APPE year survey that collected data on demographics, curricular and co-curricular experiences, and the 19-item modified metacognition assessment inventory (MAI). Additionally, the post-APPE survey collected data on learning activities completed during the APPE year. Matched survey responses were analyzed to identify associations between change in MAI score and individual experiences.Results. One hundred thirty-nine matched responses were analyzed. A significant improvement in overall student pharmacist metacognition was seen in matched pre- vs post-APPEs surveys. Several significant, moderate to weak correlations were associated with a change in MAI score over the APPE year.Conclusion. The APPE year resulted in a significant change in student pharmacists' metacognition at five institutions. This improvement was multifactorial as individual factors had minimal association with the change in metacognition.

Scholarly maturation and other factors supporting publishing productivity in educational scholarship for clinical faculty.

INTRODUCTION: In order to advance curricula and faculty career progression, it would be helpful to increase publishing success and productivity in educational scholarship. The objective of this study was to describe the key factors and strategies that contribute to publishing success and productivity in the publication of educational scholarship by clinical pharmacy faculty. METHODS: Participants were identified from 2007 to 2016 PubMed and Science Direct publication records or by having received the American Association of Colleges of Pharmacy Emerging Teaching Scholars Award. Participants were required to have an active clinical practice and not have administrative positions or doctor of philosophy training. Qualitative data were gathered through dyadic and individual interviews and analyzed to identify core factors contributing to publishing success and productivity. RESULTS: Nine clinical pharmacy faculty participated in dyadic or individual interviews, including seven associate professors and two professors. Participants' teaching and learning publications covered two to 13 topic areas, and participants had 20 to 70 unique co-authors. Five core factors and 17 strategies were identified as supporting publishing success and productivity in educational scholarship. The five factors included inputs/assets, the team, the project, the process, and scholarly maturation. CONCLUSIONS: Participants' responses confirm some conceptions, while also disputing common misconceptions that may discourage clinical faculty from pursuing educational scholarship. Fundamental research skill development is required in educational scholarship as in other scholarly areas. In addition, the roles of team building, receiving and providing mentorship, and the development of small significant networks merit further investigation as assets to productivity.

Use of a script concordance test to evaluate the impact of a targeted educational strategy on clinical reasoning in advanced pharmacy practice experiential students.

BACKGROUND AND PURPOSE: It is unclear how clinical reasoning is impacted by a single advanced pharmacy practice experience (APPE) and how preceptors can further develop these skills. EDUCATIONAL ACTIVITY AND SETTING: Students completing an APPE within four sites were invited to participate. To assess clinical reasoning skills, students completed a 30 item script concordance test (SCT) during week 1 and week 5 of a rotation. Students were divided into control and intervention groups. The intervention group participated in a clinical reasoning discussion, during which students presented a case and led a discussion on how to reason through treatment options. FINDINGS: Change in mean SCT scores between week 1 and week 5 were 0.84 (2.8%) and 1.23 (4.1%) in the control (n = 15) and intervention groups (n = 28), respectively. There was no significant change in scores in the control group (P = .07, CI -0.34, 2.01). The change in scores was statistically significant in the intervention group (P = .02, CI 0.23, 2.23). An independent samples t-test comparing the SCT score change for the control and intervention group showed no significant difference (P = .62, CI -1.18, 1.96). SUMMARY: This study demonstrated the feasibility of implementing a SCT in experiential education. SCT scores did not significantly improve beyond the standard APPE in response to the focused educational intervention, but investigators found that the discussion facilitated rich conversations about patient cases and was valuable for assessing a student's thinking pattern.

Faculty preceptors' strategies for teaching clinical reasoning skills in the advanced pharmacy practice experience setting.

INTRODUCTION: Clinical reasoning is essential to providing quality patient care. However, advanced pharmacy practice experience (APPE) students may struggle with the real-life aspects of patient care, and it may be difficult to quickly identify these students in order to make meaningful interventions. The purpose of this study was to explore pharmacy faculty preceptors' strategies for identifying gaps and teaching clinical reasoning in the APPE setting. METHODS: A qualitative study utilizing 30-min, one-on-one phone interviews was conducted with faculty members from two schools of pharmacy. Faculty participants were invited based on their APPE preceptor role and expertise in adult general medicine. Interview questions collected faculty demographics and reflections on evaluation and instruction of clinical reasoning skills. Demographics were analyzed using descriptive statistics. Thematic analysis was completed to identify themes from qualitative interview data. RESULTS: Fifteen faculty preceptors participated. The cohort had an average of 17.1 pharmacy practice years and an average of 11.9 faculty member years. Interviews yielded a 7735-word document for data analysis, which resulted in 11 themes. CONCLUSIONS: This study explored pharmacy faculty preceptors' strategies for identifying gaps in clinical reasoning and their instructional methods to improve those skills, which resulted in 11 themes. Future directions include implementation of a standardized clinical reasoning assessment tool in the APPE setting and exploration of targeted educational interventions.

Using a design-based research framework to refine a desirable difficulties activity for sterile compounding in a skills-based laboratory course.

BACKGROUND AND PURPOSE: Design-based research (DBR) processes aim to connect educational research with instructional techniques by focusing on the development and evaluation of multiple iterations of learning activities for systematic improvement within learning environments. Desirable difficulties (DD) are purposeful challenges introduced to facilitate deeper learning of material. The purpose of this work was to evaluate a second iteration of a sterile compounding DD study in the context of DBR in order to allow for the identification and refinement of the educational methods. EDUCATIONAL ACTIVITY AND SETTING: In this second iteration, doctor of pharmacy students in their second professional year were exposed to both a mechanical and mathematical difficulty in sterile compounding training. Afterwards, students completed a questionnaire to rate their change in confidence and reflect on the activity. FINDINGS: An increase in confidence in sterile compounding skills was seen by the majority (97.9%) of students. Students' reflections highlighted gains in strategic knowledge, split between internal and external strategies. SUMMARY: Course instructors saw value in the refinement of a DD sterile compounding activity and plan to continue incorporating DBR processes in order to allow for the further improvement of this educational method. Faculty at other institutions could apply these processes to further refine a variety of educational activities.

Lessons learned from an investigation exploring association between grit and student performance in a pharmacy skills laboratory course.

BACKGROUND: A challenge for many pharmacy educators is early identification of students who may struggle with various aspects of the pharmacy curriculum. While grade point average, demographic factors, and personality traits may be helpful considerations, we felt there was a need to further explore methods for readily identifying at-risk students who may benefit from early intervention. The Grit Scale has recently been explored, presented, and published in academic pharmacy. The goal of this study was to determine if there was an association between students' grit scores and performance on a laboratory practical examination. However, it became apparent that there were substantial limitations leading to difficulties analyzing and interpreting our study data and results. IMPACT: The interpretation of data was confounded due to study design limitations, including use of the Grit-O scale (rather than Grit-S), low response rate, and lack of validation evidence for laboratory practical assessments. RECOMMENDATIONS: Thoughtful consideration during the design of the study may have produced better data for analysis. Psychometric considerations are paramount, both for the instrument (Grit-O) and the dependent/outcome variable (laboratory practical assessment). DISCUSSION: While this study did not yield meaningful results for interpretation, it highlighted important lessons for investigators at the college to use moving forward. We hope that the lessons learned from this investigation might support the academy in improving design and rigor of educational research.

Comparison of faculty and student self-assessment scores of aseptic technique skills and the impact of video review on self-awareness for second-year pharmacy students.

BACKGROUND AND PURPOSE: Educating students about aseptic technique presents many challenges. Students at Drake University have limited exposure to this skill outside of the classroom setting, and students have previously shown a lack of awareness related to their own aseptic technique skills. One approach to developing self-awareness in this area may be the incorporation of activities involving video viewing and self-reflection. EDUCATIONAL ACTIVITY AND SETTING: Second-year pharmacy students in the Intermediate Pharmacy Skills and Applications 2 course completed four total aseptic technique activities, each of which was assessed by faculty using a standardized assessment tool. Each student was video-recorded during one of these aseptic technique activities. Students were asked to self-reflect on their performance immediately after the activity and again after viewing the video recording of their performance (using the same criteria included in a standardized faculty assessment tool). Student self-reflection scores before and after video viewing were then compared to faculty scores. FINDINGS: One-hundred six students participated in the video recording and self-reflection activity. Compared to faculty assessment scores, there was no significant difference between the self-reflections before or after video viewing (p = 0.571). DISCUSSION: Video self-reflection had no significant impact on the ability to accurately self-assess aseptic technique skills, but this study did reveal several other opportunities for future teaching and research. SUMMARY: Future efforts to impact student self-awareness should include additional self-reflection instruction, repeated self-reflection activities conducted over the course of a semester, and improved video recording technology.

Utilizing desirable difficulties for sterile compounding training in a skills-based laboratory course.

BACKGROUND AND PURPOSE: Sterile compounding skills are essential components of a professional pharmacy curriculum. The theory of desirable difficulties has been used to facilitate deeper learning of material in other disciplines, but has not been described in pharmacy sterile compounding instruction. The purpose of this work was to evaluate whether challenges introduced in sterile compounding would act as desirable difficulties and result in greater student confidence in their sterile compounding competency. EDUCATIONAL ACTIVITY AND SETTING: Students in the fourth semester of Pharmacy Skills and Applications, a laboratory-based skills course, were presented with challenges in sterile compounding and were asked to complete a questionnaire rating their confidence and describing their experience. FINDINGS: The majority (92.8%) of students reported that the activity increased their confidence in their sterile compounding skills. Students' open-ended responses suggested that most of the knowledge gained was strategic in nature. DISCUSSION: The results of this activity met the instructors' initial goals by positively impacting students' confidence in their ability to overcome challenges with sterile products compounding. Course instructors may explore additional skills in which to introduce desirable difficulties in order to build student confidence. SUMMARY: Course instructors were pleased with the implementation and results of this desirable difficulties activity and plan to continue its use again in future semesters. Incorporating more real-world challenges throughout the skills-lab course may be beneficial to student learning and confidence. With thoughtful planning, faculty at other institutions can readily incorporate similar activities within their own courses.

A Journey to Understand Enjoyment in Academic Writing.

To assist academic writers in finding enjoyment in writing, this paper draws a distinction between enjoying the process of writing and enjoying the nature of writing. Based on an examination of academic writing literature, analysis of personal experiences, and a review of the positive psychology literature, conditions that support writing enjoyment are posited. Readers are invited to examine their personal experience with writing enjoyment relative to these levers. Concrete actions for authors to improve enjoyment in writing are suggested based on the theories discussed, including actions to support flow, creativity, curiosity, courage, mindset, purpose, and humility.

It's no debate, debates are great.

INTRODUCTION: A debate can be a pedagogical method used to instill essential functions in pharmacy students. This non-traditional teaching method may help to further develop a number of skills that are highlighted in the current Accreditation Council for Pharmacy Education Standards 2016 and Center for the Advancement of Pharmacy Education Educational Outcomes 2013. COMMENTARY: Debates have also been used as an educational tool in other health disciplines. Current pharmacy literature does illustrate the use of debates in various areas within the pharmacy curriculum in both required and elective courses; however, the current body of literature would suggest that debates are an underutilized teaching tool in pharmacy experiential education. IMPLICATIONS: With all potential benefits of debates as a teaching tool, pharmacy experiential preceptors should further explore their use in the experiential setting.

Impact of debates on student perceptions and competency scores in the advanced pharmacy practice setting.

BACKGROUND AND PURPOSE: Advanced pharmacy practice experience (APPE) students are faced with the difficult reality that there is rarely one correct answer to a patient care question. Faculty preceptors developed a clinical debate activity to provide students with an opportunity to explore pharmacy topics with competing viewpoints. EDUCATIONAL ACTIVITY AND SETTING: The clinical debate activity was implemented in the APPE setting as a collaboration between three faculty preceptors from Drake University and University of Iowa. Student pre-debate and post-debate survey data was collected to assess the perceived impact of clinical debates on student confidence in skills related to the debate. Students were also asked to provide which skills were developed through the debate, whether participation in the debate changed their opinion on the issue, and if debates should be used as a teaching tool. Faculty preceptor scores on midpoint and final evaluations for applicable APPE competencies were also evaluated. FINDINGS: Forty-two students participated in a clinical debate over a 12-month period. Students demonstrated improved confidence in almost all areas assessed, and 90.5% of students felt debates should be used as a teaching tool. Assessment of faculty midpoint (pre-debate) and final (post-debate) evaluation scores revealed statistically significant improvements in competencies related to literature evaluation and communication skills. DISCUSSION AND CONCLUSIONS: Clinical debates have had a positive impact on both subjective and objective results in this APPE setting. Preceptors are encouraged to consider implementing a similar activity. Debates are a useful teaching tool in developing confidence and skills.

Toolkit for US colleges/schools of pharmacy to prepare learners for careers in academia.

INTRODUCTION: The objective of this article is to provide an academic toolkit for use by colleges/schools of pharmacy to prepare student pharmacists/residents for academic careers. METHODS: Through the American Association of Colleges of Pharmac (AACP) Section of Pharmacy Practice, the Student Resident Engagement Task Force (SRETF) collated teaching materials used by colleges/schools of pharmacy from a previously reported national survey. The SRETF developed a toolkit for student pharmacists/residents interested in academic pharmacy. RESULTS: Eighteen institutions provided materials; five provided materials describing didactic coursework; over fifteen provided materials for an academia-focused Advanced Pharmacy Practice Experiences (APPE), while one provided materials for an APPE teaching-research elective. SRETF members created a syllabus template and sample lesson plan by integrating submitted resources. Submissions still needed to complete the toolkit include examples of curricular tracks and certificate programs. DISCUSSION AND CONCLUSIONS: Pharmacy faculty vacancies still exist in pharmacy education. Engaging student pharmacists/residents about academia pillars of teaching, scholarship and service is critical for the future success of the academy.

Comparison of electronic versus paper rubrics to assess patient counseling experiences in a skills-based lab course.

BACKGROUND AND PURPOSE: To evaluate an electronic counseling rubric to facilitate timely student feedback and explore differences in student performance, student anxiety, and self-perceived preparedness in a high stakes practical exam when using a paper rubric versus an electronic rubric. EDUCATIONAL ACTIVITY AND SETTING: Two cohorts of students in the third professional year were evaluated using the same rubric criteria: cohort 1 (n = 97) used traditional paper rubrics and cohort 2 (n = 104) used electronic rubrics. Cohorts were surveyed to measure anxiety and perceived preparedness in patient counseling skills one week prior to a practical exam, and cohort responses were compared. Student practical exam performance was also compared between the two cohorts. FINDINGS: Results showed no significant relationship between electronic rubric use and student anxiety (p = 0.07) or student exam performance [average score 53.42 points (SD 3.65) and 53.93 points (SD 3.78) in Cohort 1 and Cohort 2, respectively]. Perceived exam preparedness was higher among students using electronic rubrics, with timing of feedback being the mediating process in increasing preparedness (p < 0.01). DISCUSSION AND SUMMARY: Electronic rubrics resulted in more timely feedback on patient counseling skills, and students felt more prepared for their practical exam. This did not result in a significant difference in practical exam performance between the two cohorts. Additional methods to incorporate electronic rubrics into the course will be explored.

Use of a health screening and education event to change student attitudes toward the elderly.

BACKGROUND: While many schools have incorporated geriatric pharmacy education into their curricula, questions remain as to how these experiences shape student perceptions of the geriatric population. The objective of this study was to assess student comfort levels and perceptions toward the geriatric patient population before and after participation in a single health screening and education event. METHODS: Student perceptions about the elderly (measured via the Geriatrics Attitude Survey) and comfort levels in caring for geriatric patients were assessed before and after an event. RESULTS: Twenty-two students completed pre-event and post-event surveys. Students were primarily female (73%), and half were completing their second year of pharmacy school (50%). Global student perceptions of geriatric patients positively changed from baseline following event participation (p = 0.023). Results reveal significant increases from baseline in student comfort levels with communicating, screening, and counseling elderly patients (p < 0.001, 0.01, and 0.001, respectively). CONCLUSION: The Geriatrics Attitude Survey is a useful tool in assessing the value of a geriatric experience. Participation in this geriatric experience caused a statistically significant positive change in global perception scores. Additionally, survey results indicate that interactions with geriatric patients at a single event increased student comfort in communication, screening, and counseling.